GENDER TALKS | Season 2 Episode 04: Health Issues & Sexual and Reproductive Health

[music] Good day everyone. and welcome back to another episode of Gender Talks here on TVP. We've covered a range of topics in our past episodes and now we are back with another interesting and crucial topic. This time about the key health services necessary for women and the LGBTQI community and the gaps in their provision. Before we begin, I'm Nati Africa Verscelles from the department of women and development studies and with me today are I'm Laka Numali from the department of English and comparative literature. >> I am Ena Gakad from the department of women and development studies. Okay, let's first take a closer look into the health services most crucial for men who have sex with men or MSM. Transgender individuals and other high-risk groups including those that are currently underprovided or inaccessible starting with those related to the human immuno deficiency virus or HIV. So I have a question. What specific steps can be taken to ensure that at risk groups receive the crucial HIV related health services they need without the barriers of stigma and discrimination? I think people living with HIV vulnerable group for example men having sex with men or trans people. So I think that stigma HIV medical condition for example contract HIV it is a disease like every disease and everyone is susceptible to it. It's not like you can only get it if you're a quote unquote or if you engage in promiscuous behavior. Even if you're straight, even if you're heterosexual or you're sis, you can still get HIV. So I think addressing stigma. >> I agree. And a major barrier to I think [clears throat] still is also stigma. And many members of the LGBTQI community are judged and viewed as quote unquote morally unclean often influenced by you know our religious beliefs. So with that no what strategies can be implemented to reduce this stigma and encourage more open and inclusive health discussions within communities cuz that will help dstigmatize the topic of HIV and other sexuality issues discussion that should really happen is there's no problem if people want to have sex >> basta they are having sex with people that want to have sex with them as well. Um, and then also recognizing the value that sex creates, which could be intimacy, which could be a sense of love or a sense of joy, wedding forever, wedding for now, but recognizing that it is valuable an interaction. And then second looking at categories, joy, connection, intimacy and then tell each other how unfair that whole enterprise in society is. And once we start to open up the discussion about sex, it will easily allow for the risks that are associated with sexual intimacy to be discussed as well as something that is part of the engagement between two people. Um and then finally again with our now modern very scientific efforts to curb and combat disease. Now, as long as you get access to a trained professional, as long as you get access to testing, and as long as you get access to preventive or curing measures, technically even if you live with HIV, [clears throat] >> you have to add something. >> I want to add that HIV and scientific advancements vulnerable or HIV. People living with HIV can live perfectly normal lives so long as awareness and access to medical care and medical facilities. So, it's not something to be ashamed of and it's not something to be hidden. Of course, But neverly pressure a person living with HIV to come out to disclose their status. No, but at the same time should be aware that there are many people living you know living with us know possible colleagues, friends, workmates, people living in the same apartment building who might have HIV which is fine and which is like any other medical condition that a person might contract throughout their lifetime and it's not something to be scared of and it's not something to be ashamed of. That's a nice way to look at HIV because the tendency nice to see it as a death sentence. There are also continuous misconceptions about how you can even catch it anybody. They think that it's so easily transmissible etc. And also it's because it's um very um predominantly seen no among um transgender communities or MS and men having sex with men. stigmatized but in reality it's an illness just like any illness and it can be controlled by anti-retroviral therapy for instance okay so um there are also problems that people living with HIV face in workplaces and there have been no cases wherein they have lost their jobs because of their HIV status so what do you think no to protect this community of people living with HIV who are employed. No, how can we strengthen legal protections no and workplace policies to ensure that this these people living with HIV are not discriminated against? Employment and livelihood. >> Yeah. Um top of mind is the implementation of the laws we already have like safe spaces act um antisexual harassment at different levels in the workplace workplace policy anti-discrimination efforts workplace policy and embedded into each of these policies and supplemented by the force of the law you responsibility now employers to maintain all information about their staff now to be private and confidential. Second, actually my question is why would you have to ask the HIV >> all these details about a person who's working with you unless you had to know the health status particular health details that are relevant to the job here. So sometimes people or employers assume that they have the right to know absolutely everything about one of their employees or all of their employees and then make a decision about the fitness of a person to continue on the job based on obscure health things that are not even related. >> And then that is just basically flatout discrimination. but they will make it look as if they're only looking out for the well-being of that person or their company. And a lot of these things really do require for us to look inward and say what is the intention for all of us having this access to information about other people. >> True. Protections that are provided for by the law without giving up so equality bill. >> We need the equity. So let's start with that and then let's go back to the issue of HIV. No, a second major barrier to getting tested are the many misconceptions no about HIV because we want to continue to educate our audience. No, people often think that if they're physically fit or don't have any symptoms, there's no need for testing and then if they're monogamous, they also think that I I'm protected no from HIV. [clears throat] So with that, what strategies do you think can be implemented to correct these harmful myths? No. And promote regular HIV testing as part of routine health care for everyone, not just members of the LGBTQI community, for everyone cuz all of us are actually at risk. Can you just give us an idea? >> I think emphasize testing in addition to it being something to secure oneself. No, I remember that in a couple of years ago for HIV of course important important part counseling both pre and post test counseling home test kit to test if you have HIV which is very convenient no and it's something which certain organizations give out for free so it's something that a person can easily do in the privacy of their own home healthare provider which again it's there's nothing wrong with being seen there sense of shame that a lot of people uh or or or timidness that a lot of people experience. So it's something getting tested it's something you can do as easily as getting a using a COVID test on yourself. >> It's reliable as well. >> Yes, it's reliable. >> Is it financially prohibitive? How much do these tests >> I got some tests for free? Yeah. Yeah. Libra pa. >> Okay. That's important cuz we know for a fact that access to testing services h outside no is limited. There were only 180 designated HIV treatment facilities in the Philippines as of last year. So how can we expand access to HIV testing? Do we need to expand it if we can have pa these home kits? But do you think we should still expand access to HIV testing and treatment services across the country especially in areas that are underserved? >> I think expanding access to sexual health in general because in hospitals for example there are so many different kinds of fields of medicine uh targeting different kinds of bodily ailments from for example uh respiratory ailments or uh digestive ailments that support for when it comes to sexual health. Yeah. >> Oh, sexual health which brought up the fact that enjoyment of sexual health. How come we feel that we have to deny ourselves the joy of sexual health? because to contract an STI or to contract HIV would be seen as a scarlet letter and be seen as a morph against their person. It's not okay and it's not just HIV. It's there are a number of STI that anyone can really get no matter how safe or no matter how monogous you think you are. So in addition to expanding um support for people living with HIV for HIV testing facilities, I think expand medical support for sexual health in general. Yes. >> Okay. But we still know also that there is a fear of testing positive. You're you're fearful of the results which could be positive and also what comes after that no can be overwhelming for many. And you said there is counseling that is given. But what more people should know is that HIV like we already mentioned earlier with anti- anti-retroviral therapy people living with HIV can reduce the viral load to undetectable levels now making it actually impossible not to transmit a virus and to live perfectly normal lives. No. So how can health campaigns more effectively communicate the advancements in HIV treatment? I mean some do advancements other advancements like there's a team from UP Manila that is investigating the efficacy of a plant. Have you heard about this lang? It's a plant extract that is used to treat HIV especially given the rise of drug resistance in the country and art's instability to target latent infection. So art okay art highly effective but there are still barriers to uptake [clears throat] and adherence. So art can be be accessed at designated treatments facilities which is a problem for those in areas without HIV hubs. So while the therapy itself is free for pe people living with HIV, patients often face additional costs for lab services again no and consultations making treatment challenging for many. So other um therapies ar instance you were not even aware that there's that plant extract developed in UP Manila. So there's a communication problem also perhaps >> there's a communication problem and I think it's also tied to the fact that continuing to demonize people living with HIV and exaggerating the effects of the disease I think they serve certain political ends now >> elaborate can you elaborate on the political ends >> more conservative people would like to use HIV as a kind of boogeyman or as a sign that people who are queer here. People who are gay or transgender will naturally get punished by God. >> Oh, okay. So, like it's like a punishment that you're supposed to fear. >> Yes. >> And that's how it was taught to us when I was in Catholic high school. Yes. Yes. That HIV is God's punishment to gay people. >> Yes. So, so what do you think about this enabl shows us as a level of acceptability for treatments like arts or even testing for HIV and in general sexual health? Um, and I just remember my first time to get tested for all the sexual health concerns was when I was in grad school in offer Libra University affiliated clinic. So, Australia Amazon test for all of these things. I like okay cuz it's as simple as just extracting a blood sample from they could use for all the other tests that were on the list that I didn't even consider I should be taking. So the idea now if your health is based on health we just assume that it's always just about our feeling okay but lately we've encountered all of these ideas of self-care as in you preventive measures so that we can continue to be okay across all kinds of stresses. So if we start to see sexual health as an element of self-care, then we start to see, especially when you're sexually active, that the requirement for self-care includes professional testing, includes treatment for whatever you might encounter. That already would normalize the whole process of sexual health. And then maybe eventually, maybe 10 years from now, it's not as scary, it's not as offensive, it's not as stigmatized, but integrating it into the more popular notions of self-care could be a good start. I've noticed also a lot of the young LGBT orgs doing all these reals on Tik Tok and Instagram with influencers just incorporating the conversation on sexual health and testing in their entertaining reels. So gan class pop education approach that is a conversation that two random friends could have as opposed to a person sitting with a very serious doctor >> telling them the most dramatic result of a testa even that treatment of how we talk about these issues could do a lot in terms of dstigmatizing testing and access to medication >> cuz it really should not be any different from all the other health tests only because again of that entire stigma when it comes to issues of sex and sexuality that even testing becomes something that is not talked about or even done. I was just reflecting also idea is a very appreciation of Medicate. So there is also very a very real economic factor that prevents people from accessing services such as um testing and treatment. So intersectional gender, economics and poverty and then the very dismal state of our health system and gaps needs and then s ability system to provide. So at the minimum having these conversations and even normalizing fear now what if and then letting people know actually you communities around HIV prevention they are the most loving most welcoming people that one could ever possibly meet and to be honest never in your journey if you are trying to heal or recover because there will always be a community around you. So again, it's about raising awareness in critical consciousness. Oh, there's another key health topic no that I want to talk about and it's gender affirming hormone therapy no or HRT which is a key component of many transgender individuals gender transitioning. So Lan, you have to walk us through this. No. How does HRT help transgender individuals transition? >> Uh well, [clears throat] HRT helps transgender individuals transition by helping the outside match the inside. Uh for example, you know, mentally, emotionally, I've always identified womanhood with femininity. And the bo but the body I was born in was a male body. So HRT helps my body be a bit more feminine, look like, feel like, even sound like the kind of body that I'm more comfortable with, the kind of body that I want. HRT is not necessary for every trans person. No, there are many trans people who do not take hormones or do not transition medically and that's fine. But for a lot of trans people, it's another step towards the process of becoming, you know, becoming the person that we want to be. So it is an affirming yes intervention for trans individuals. >> But there are though significant barriers to accessing gender affirming health care. So can you tell us what measures based on your experience can be taken to ensure that gender affirming treatments such as HRT are accessible, affordable and supportive of the needs of the transgender community. For those who want to transition medically, like you said, not everyone, not all transgender individuals are interested. For those who are want to be able to support them, tell us how. So I think part of improving the healthare system would mean that it should be more inclusive and I think it should be more inclusive towards the needs of trans people like for example um ensuring that trans people have easy access to endocrinologists or psychiatrist therapists who might help us through the process of transitioning that lab tests which are needed to determine and if it's safe for someone to transition or what dose would be safe for them to take that lab tests are at least subsidized or cheap so that they're affordable because sometimes they can reach 6,000 pesos which not everyone can easily afford. >> Ideally, hormones should be easily available in in drugstores because often times they're out of stock much like many other necessary medications uh in the Philippines. So those were some steps I think to to ensure the trans people get the transaffirming healthcare that we have a right to. >> We hope that we will be able to reach that point where all our trans individuals are are given no or or have access to transaffirming healthcare. Now let's turn to human the human papilloma virus. No. Um this is uh more concerning. No, cuz me strains that can lead not more concerning but this is concerning no because there are strains that can lead to cancers of the cervix, anus, penis, vagina, valva, and even the throat. And then if you're familiar with the Mayo Clinic in the United States, no, they said that almost all cervical cancers are caused by HPV infections. And this is scary. No, it can take up to 20 years or more for cervical cancer to develop after an infection. In fact, it can go on in your body undetected. So, in the Philippines, cervical cancer is the second most common cancer among women. Ena, I'll ask you, what are the factors that can increase HPV infection? >> Social factors because we know that you're not a you're not a doctor [laughter] any kind of in the social factors. The social >> even economic economist >> social factors definitely you obscurity n information about bodies that are not male y that is definitely a hindrance to how people appreciate their bodies. And then of course you issue n again if it has to do with the female reproductive system it is something that is mystical and only meant for lifegiving daily creation activities. So again with that idea purpose females we obscure a lot of the details about health and if people didn't know that there was something they could study about their health and wellbeing they really wouldn't be looking for information to begin with um and then factor HPV vaccine and the way it comes out is [laughter] you have to pay so much to get three doses of the vaccine otherwise it's not going to be effective and it is definitely a prohibitive factor to what whether or not people would try to understand p HPV >> so we need to make the HPV vaccine more accessible >> but you have to schedule and I think it's only free for certain ages >> par may certain age definitely optimal matangap and if you're older you could still indefinitely you should still get the vaccine but sabaranga you will have to pay you will schedule and then >> so how can we do how can we improve the accessibility or or >> awareness also how do we improve awareness about >> the conversations about health >> and about sexual and reproductive health that a lot of people are not having popularizing the information Um, I guess it also will help to integrate these discussions in an overall health discussion on women or LGBTQI individuals. Making men participate in the discussion of the health of the women or female half of their families. All of these encouraging society just to be more open about discussing different aspects of health that will eventually lead to health seeking behaviors as opposed to the kinds of health discussions we're having that are very stigmatized and very uh threatening to the ideas or openness of people to look into their own body. Everything about health is stigmatized whether from the perspective of pleasure From the perspective of health, should we even proceed about to talk about sex and how? No. So topic today and we hope that each has broadened your understanding of gender and health issues. Let's continue to push for health care systems. Let's continue to end the stigma towards sex and sexuality. No, that are designed. We should work towards systems that are designed to serve individuals of all genders equitably and respectfully Africa Verselles. >> I'm Laka Numali. >> And I'm Ena Dhaka. And we'll see you next time on Gender Talks. >> [music] [music] >> Heat. Heat. >> [music] >> Heat. Heat. >> [music]